This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. Type 2 diabetes mellitus (DM 2), a serious, chronic, age-related disorder strongly linked to the insulin resistance syndrome (IRS), is a leading cause of death and disability in the United States and is fast reaching epidemic proportions both nationally and globally. There is growing evidence that yoga may offer particular promise for the management of DM 2 and prevention of cardiovascular sequellae, and may provide a safe and cost-effective means of addressing the multiple, interrelated factors underlying this complex, devastating, and rapidly increasing chronic disorder. However, research in western populations with DM 2 is limited, and rigorous, systematic studies regarding the effects of yoga on physiological, anthropometric, and psychological profiles in diabetic adults are lacking. The proposed pilot study will use a randomized controlled design to investigate the effects of an 8 week structured Iyengar yoga program on insulin sensitivity and other related metabolic and psychological indices of CVD risk in adults with Type 2 diabetes. Participants will be 46 patients aged 50-75 who have an established diagnosis of DM 2 and are enrolled in the UVA Diabetes Education and Management Program (DEMP). Eligible participants will be randomized into yoga or control groups, stratified on gender and race/ethnicity. Our primary aim is to evaluate the effects of Iyengar yoga on change in insulin sensitivity as estimated by the QUICKI, a measure that combines excellent reliability and validity with minimal subject burden. Our secondary aims are: 1) to assess the effects of yoga on other markers of insulin resistance (fasting glucose, insulin, glycated hemoglobin, fructosamine, post-prandial glucose), and related CVD risk indices, including measures of sympathetic activation, dyslipidemia, endothelial function, inflammation, coagulopathy, visceral adiposity, insulin-like growth factor bioavailability, psychological morbidity, and sleep disturbance;and 2) to evaluate and optimize the overall protocol design, including recruitment, and retention rates, protocol adherence, and instrument burden in both minority and non-minority participants. The intervention will comprise 8 weeks of structured Iyengar yoga training, including two 90-minute classes/week in addition to daily directed yoga practice at home. All participants will continue to receive usual care and to participate in the DEMP program. Controls will also receive coupons for 6 yoga classes upon completion of the study. Before and after the 8 week treatment period, fasting blood samples will be collected, and specific markers of insulin sensitivity and other physiological, anthropometric, and psychological indices associated with insulin resistance and DM 2 will be measured. Findings of this study will 1) provide critical preliminary and feasibility data to support larger, multi-ethnic randomized clinical trials investigating the influence of yoga practice on insulin resistance and related metabolic and psychologic indices in older adults with type 2 diabetes;and 2) yield important preliminary information on the potential utility of yoga in managing DM 2.